Dentistry is a messy job. From scraping plaque to removing cavities, procedures send saliva, contaminated water and bacteria from patient mouths into the air. And during the COVID-19 pandemic, those routine practices make dentistry an increasingly high-risk occupation. child at the dentist

“Almost everything done in the chair produces aerosols,” said Josefine Ortiz Wolfe, PhD, RDH, CHES, chair of APHA’s Oral Health Section and director of oral health at the Texas Health Institute. “There is a tremendous amount of risk there, and providers have had to adjust practice based off a lot of unknowns with this virus.”

During the early months of the pandemic, many dental offices closed entirely, or only saw patients for emergencies, leaving dentists, hygienists, assistants and other staff out of work. Now that they are slowly reopening, practices are balancing the health dangers posed by the pandemic with economic pressures and requests from patients who have gone months without care.

About 1 in 5 dental offices in the U.S. were completely closed and not seeing any patients in late March, and 3 out of 4 were only seeing emergency patients, according to a poll from the American Dental Association’s Health Policy Institute. More practices began reopening in May with fewer patients, and as of mid-June, almost all dental practices were open in some capacity, with about one-third describing their practice as “business as usual,” the poll said.

To protect both workers and patients, dental offices have made sweeping changes, following guidance from professional organizations and industry experts. They have altered the kinds of protective gear they use, limited the number of patients they see per day and, in some offices, invested heavily on specialty equipment to make offices safer.

But more guidance is needed, according to APHA’s Oral Health and Occupational Health and Safety Sections, which called for better information from the federal government on how dentists should operate their offices given the pandemic. Dental teams have the highest occupational risk among all workers, with hygienists the single highest-risk profession, the Sections said in a June letter to U.S. Health and Human Services Secretary Alex Azar, JD.

Continue reading this story from the August 2020 issue of The Nation's Health.

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